Severe endothelial injury and subsequent repair in patients after successful cardiopulmonary resuscitation

Ischemia and reperfusion after cardiopulmonary resuscitation (CPR) induce endothelial activation and systemic inflammatory response, resulting in post-resuscitation disease. In this study we analyzed direct markers of endothelial injury, circulating endothelial cells (CECs) and endothelial micropart...

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Bibliographic Details
Published in:Critical care (London, England) England), 2010-01, Vol.14 (3), p.R104-R104, Article R104
Main Authors: Fink, Katrin, Schwarz, Meike, Feldbrügge, Linda, Sunkomat, Julia N, Schwab, Tilmann, Bourgeois, Natascha, Olschewski, Manfred, von Zur Mühlen, Constantin, Bode, Christoph, Busch, Hans-Jörg
Format: Article
Language:English
Subjects:
Aged
Analysis
Biomarkers
Cardiopulmonary Resuscitation - adverse effects
Care and treatment
Cell-Derived Microparticles - metabolism
Complications and side effects
Coronary Artery Disease - physiopathology
CPR (First aid)
Diagnosis
Endothelial Cells - metabolism
Endothelium
Endothelium - injuries
Endothelium - physiopathology
Female
Flow Cytometry
Humans
Injuries
Male
Middle Aged
Physiological aspects
Prospective Studies
Regeneration
Reperfusion injury
Risk factors
Stem Cells - metabolism
Trauma Severity Indices
Wound Healing - physiology
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Summary:Ischemia and reperfusion after cardiopulmonary resuscitation (CPR) induce endothelial activation and systemic inflammatory response, resulting in post-resuscitation disease. In this study we analyzed direct markers of endothelial injury, circulating endothelial cells (CECs) and endothelial microparticles (EMPs), and endothelial progenitor cells (EPCs) as a marker of endothelial repair in patients after CPR. First we investigated endothelial injury in 40 patients after CPR, 30 controls with stable coronary artery disease (CAD), and 9 healthy subjects, who were included to measure CECs and EMPs. In a subsequent study, endothelial repair was assessed by EPC measurement in 15 CPR, 9 CAD, and 5 healthy subjects. Blood samples were drawn immediately and 24 hours after ROSC and analyzed by flow cytometry. For all statistical analyses P < 0.05 was considered significant. There was a massive rise in CEC count in resuscitated patients compared to CAD (4,494.1 +/- 1,246 versus 312.7 +/- 41 cells/mL; P < 0.001) and healthy patients (47.5 +/- 3.7 cells/mL; P < 0.0005). Patients after prolonged CPR (>or=30 min) showed elevated CECs compared to those resuscitated for
ISSN:1364-8535
1466-609X
1466-609X
1364-8535
DOI:10.1186/cc9050